Monkeypox, Measles, Swine Flu: Infectious Diseases Other Than Covid Kept India On Its Toes In 2022

Yearender 2022: The year saw the country battling multiple infectious and mosquito-borne diseases even as it managed to keep a lid on Covid-19 cases.

A medical health worker attends Covid patients in Delhi

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Even though India managed to keep a lid on Covid-19 cases this year, 2022 saw the country battling multiple outbreaks like monkeypox, measles, tomato fever, swine flu as well as vector-borne diseases like dengue and chikungunya. Infectious diseases remained one of the major causes of human mortality in the country, keeping the healthcare system on its toes.

Reasons Behind Emergence Of Viral Infections

With Covid taking our eyes off other health conditions, several experts have flagged that some children in India missing their measles vaccine due to disruptions caused by the pandemic could have led to the surge in measles cases.

Similarly, in the last two years, mandatory masking norms by the government helped reduce the number of other diseases, especially those that spread through the respiratory route. Masking was the reason behind seasonal influenza cases in 2021 in India being very low.

Infectious diseases expert Dr Ishwar Gilada said the year has seen India grappling with one viral infection after another and sometimes there are syndemics (two or more epidemics together).  

"This comes when we are just coming out of the Covid-19 pandemic as it has now reached an endemic state, at least in India," Dr Gilada told ABP Live.

"This is an era of viral infections. We have effective antibiotics for bacterial infection, effective antifungal agents for fungal infections and anti-parasitic drugs for parasitic infestations. However, there are hardly any perfect antivirals and hence viral infections keep emerging and reemerging," he added.

READ | EXPLAINED: What Is Tomato Flu? All About The Outbreak In Kerala

Steps Taken By Govt

The government has already started working on a plan to effectively combat public health emergencies and disease outbreaks in future. Experts have predicted that zoonotic diseases would be big in years to come.

About 60 per cent of known infectious diseases in humans and 75 per cent of all emerging infectious diseases are zoonotic in origin, with two-thirds originating in wildlife, according to an UN report.

In a step towards building India's capacity to face future pandemics and contagious diseases, Prime Minister Narendra Modi on December 12 laid the foundation stone for the National Institute of One Health (NIO) to be established at a cost of over Rs 110 crore.

The institute will focus on increasing preparedness and laboratory capabilities for the identification of novel and unknown zoonotic agents, a Health Ministry statement said.

Other than Covid-19, these are some of the disease outbreaks that hit India in 2022:

1) Monkeypox

The year 2022 saw the first major outbreak of the viral disease outside Africa and has infected more than 80,000 people globally, leading the World Health Organization to declare it a global health emergency — the highest alarm it can sound.

Monkeypox is a poxvirus and belongs to the same family as the now-eradicated smallpox.

Most of the monkeypox cases this year were reported from Europe, primarily among men who have sex with men (MSM).

In India, 23 confirmed cases of monkeypox have been reported till December 8 this year, Minister of State for Health Bharati Pravin Pawar told the Rajya Sabha during the Parliament winter session.

As monkeypox cases continued to pop up in the first half of the year, the Centre ramped up health screening at ports and airports of all international travellers and asked citizens to avoid close contact with "people with skin lesions or genital lesions".

2) Measles

The second half of 2022 saw a rapid spurt in cases of measles, a viral respiratory illness whose transmission is similar to Covid-19, in India even though the country had made remarkable progress in its elimination between 2017 and 2020. Maharashtra, Gujarat, Kerala, and Jharkhand have been among the worst affected states.

As per health ministry data, over 10,400 confirmed cases of measles and 40 deaths among children have been reported in India till December 12. Maharashtra accounts for the bulk of the cases (3075), followed by Jharkhand with 2,683 cases.

Experts and even the WHO have identified "lack of vaccination" as the root cause for the sudden measles outbreak. The WHO, which has declared measles to be an "imminent threat in every region of the world", said in a recent report that a record high of nearly 40 million children missed measles vaccine dose in 2021 due to hurdles created by the Covid-19 pandemic.

"The measles outbreak has been seen usually in the places where the routine vaccine coverage has been low. Secondly, during the Covid time, the people migrated from one place to another which is also a reason for this surge," Dr Tarun Bhatnagar, senior scientist at ICMR and National Institute of Epidemiology, told news agency IANS.

"During the last two-three years - during the Covid time, overall there were problems with the vaccination...Some children may have missed their vaccines somehow due to Covid related disruption of the service. Or, they may have not got the vaccine because they were moving - especially the migrants," he added.

3) Swine Flu

The delay in flu vaccination in the past two years also saw India grappling with swine flu cases. The country has registered over 11,500 swine flu cases this year, a 15-fold rise from 2021.

As per available data, more than 300 people have died due to swine flu, a respiratory illness caused by influenza strains, till October. In 2021, India had recorded only 12 deaths.

What complicated matters for doctors was the fact that both Covid and swine flu have common signs and symptoms -- fever, cough, shortness of breath, sore throat, runny or stuffy nose, body ache.

"Since the symptoms of swine flu are quite similar to the common cold as well as Covid, people often don't take it seriously in the initial stages until it becomes critical," Dr Vishakh Varma, senior consultant & HOD critical care medicine, Aakash Healthcare told IANS.

4) Tomato Fever

Another disease affecting children that has been spreading in the country is Tomato fever or Hand, Foot and Mouth disease (HFMD). Kerala, Tamil Nadu, Karnataka, Assam and Odisha have seen a rise in tomato flu cases among children below five years.

Although tomato fever shows symptoms similar to Covid-19, the viral disease is not life threatening. It is so called because the disease causes rashes or blisters throughout the body that gradually enlarge to the size of tomato.

Caused by Coxsackievirus A16 (a non-polio enterovirus), which is highly contagious, the disease spreads through secretions from nose, throat and fluid from the blisters.

However, there are presently no antiviral drugs or vaccines available for the treatment of Tomato flu and the Health Ministry has said the best solution for prevention is the maintenance of proper hygiene and sanitisation.

Interestingly, a section of health experts have claimed that tomato flu could be an after-effect of chikungunya or dengue fever in children rather than a viral infection, a report in The Lancet said.

5) Dengue, Zika, Malaria

Diseases such as malaria, chikungunya, dengue and zika, spread by various mosquito species, also led to an increase in hospitalisations in the country during the monsoon season. According to health ministry data, India has registered more than 1.1 lakh dengue cases and saw nearly 90 deaths till October 31. In 2020, the country saw only 44,000 cases.

Telangana, Rajasthan, Uttar Pradesh, Andhra Pradesh, Bihar and Delhi are among the top states buffeted by dengue cases.

Chikungunya cases have also been soaring in pockets of the country though not as rapidly as dengue. Till October 31, nearly 5,400 cases have been recorded, with Karnataka and Maharashtra seeing the maximum infections. Zika cases have also been reported from these two states so far.

Experts have said vector-borne diseases were on rise probably due to prolonged rains in different parts of the country, leading to increased mosquito breeding.